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JUROR QUALIFICATION FORM Juror Badge Number

JUROR QUALIFICATION form JUROR Badge Number_____ Dear Prospective JUROR : Please answer each of the following questions completely. The contact information you provide will be used only by court employees and shall not be made available to the attorneys or parties in the cases that you may be selected to hear as JUROR . Estos formularios est n disponibles en espa ol en Si necesita m s ayuda en espa ol, llame al n mero telef nico indicado en la primera p gina del citatorio para prestar servicio como jurado. Name as it appears on the summons: _____ Legal name: _____ Mailing Address: _____ Home Address (if different): _____ City: _____ State: _____ Zip: _____ Phone numbers: Home: _____ Business: _____ Ext: _____ Cell: _____ E-mail: _____ 1.

JUROR QUESTIONNAIRE Juror Badge Number_____ Please answer all questions, 1-20, and SIGN. The Juror Questionnaire will be provided to the attorneys, parties, and judges in all cases you may be selected to hear as a juror. The answers you provide will aid in the process of selecting a jury. If you do not understand a

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